阴道微环境中解脲支原体和沙眼衣原体感染及局部炎症因子水平与子宫颈高级别鳞状上皮内病变的关系  

Relationship of Ureaplasma urealyticum infection,Chlamydia trachomatis infection and local inflammatory factors in vaginal microenvironment with cervical high-grade squamous intraepithelial lesion

作　　者：商晶[1] 叶明珠[1] 陈春燕 SHANG Jing;YE Mingzhu;CHEN Chunyan(Department of Obstetrics and Gynecology,Zhongshan Hospital,Xiamen University,Xiamen,Fujian 361000,China;不详)

机构地区：[1]厦门大学附属中山医院妇产科,福建厦门361000

出　　处：《中国微生态学杂志》2025年第1期89-93,共5页Chinese Journal of Microecology

摘　　要：目的探究阴道微环境中解脲支原体(UU)、沙眼衣原体(CT)感染和局部炎症因子水平与子宫颈高级别鳞状上皮内病变(HSIL)的关系,为该类患者的治疗提供参考。方法纳入2021年6月至2023年6月我院收治的74例HSIL患者和107例非HSIL患者。分析HSIL患者阴道微环境中UU、CT感染与局部炎症因子水平的关系。采集HSIL组(HSIL患者)及非HSIL组(非HSIL患者)的临床资料,分析影响HSIL发生的因素及UU、CT感染和局部炎症因子水平与宫颈病变程度的关系。结果HSIL组的UU/CT感染率及TNF-α、IFN-γ、IL-6、IL-8水平分别为58.11%(43例/74例)、(138.14±27.65)ng/mL、(56.66±6.17)ng/mL、(0.28±0.05)pg/mL、(0.66±0.12)pg/mL,均高于非HSIL组的27.10%(29例/107例)、(96.01±19.74)ng/mL、(49.25±7.08)ng/mL、(0.19±0.03)pg/mL、(0.47±0.09)pg/mL(χ^(2)或t=17.555、11.963、7.289、15.108、12.166,均P<0.05)。根据UU、CT感染情况将74例HSIL患者分为感染组和未感染组,感染组患者TNF-α、IFN-γ、IL-6、IL-8水平分别为(171.02±30.18)ng/mL、(67.68±18.24)ng/mL、(0.38±0.06)pg/mL和(0.89±0.17)pg/mL,均高于未感染组的(92.53±16.39)ng/mL、(41.37±8.96)ng/mL、(0.14±0.03)pg/mL、(0.35±0.09)pg/mL(t=13.135、7.403、20.475、16.112,均P<0.05)。HSIL组初次性生活年龄小于非HSIL组,HSIL组中性伴侣个数>2个、吸烟、口服避孕药、有免疫抑制剂应用史的人数比例均高于非HSIL组(χ^(2)或t=11.781、12.745、15.050、21.597、29.952,均P<0.05)。初次性生活年龄较小[OR(95%CI)=2.208(1.298~3.755)]、性伴侣个数>2个[OR(95%CI)=1.726(1.315~2.267)]、吸烟[OR(95%CI)=1.929(1.093~3.406)]、UU/CT感染[OR(95%CI)=1.701(1.138~2.542)]、口服避孕药[OR(95%CI)=2.000(1.282~3.120)]及TNF-α水平[OR(95%CI)=1.809(1.115~2.936)]、IL-6水平[OR(95%CI)=2.056(1.073~3.942)]异常升高是HSIL发生的危险因素。结论HSIL患者阴道微环境中UU、CT感染可增加局部炎症因子水平,且初次性生活年龄较小、性伴侣个数>2个以及UU/CTObjective To explore the relationship of Ureaplasma urealyticum(UU)infection,Chlamydia trachomatis(CT)infection and local inflammatory factors levels in vaginal microenvironment with cervical high-grade squamous intraepithelial lesion(HSIL),and to provide a reference for the treatment of such patients.Methods A total of 74 patients with HSIL and 107 patients without HSIL who were treated in the hospital from June 2021 to June 2023 were enrolled.The relationship between UU and CT infections and local inflammatory factors in vaginal microenvironment of HSIL patients were analyzed.The clinical data of HSIL group(HSIL patients)and non-HSIL group(non-HSIL patients)were collected,and the factors affecting the occurrence of HSIL and the relationship of UU and CT infections and levels of local inflammatory factors with cervical lesion degree were analyzed.Results The UU/CT infection rate and levels of TNF-α,IFN-γ,IL-6 and IL-8 in HSIL group with 58.11%(43 cases/74 cases),(138.14±27.65)ng/mL,(56.66±6.17)ng/mL,(0.28±0.05)pg/mL and(0.66±0.12)pg/mL were higher than 27.10%(29 cases/107 cases),(96.01±19.74)ng/mL,(49.25±7.08)ng/mL,(0.19±0.03)pg/mL and(0.47±0.09)pg/mL in non-HSIL group(χ^(2) or t=17.555,11.963,7.289,15.108,12.166;all P<0.05).According to the UU and CT infections,the 74 patients with HSIL were divided into infection group and non-infection group.The levels of TNF-α,IFN-γ,IL-6 and IL-8 in infection group were(171.02±30.18)ng/mL,(67.68±18.24)ng/mL,(0.38±0.06)pg/mL and(0.89±0.17)pg/mL respectively,higher than(92.53±16.39)ng/mL,(41.37±8.96)ng/mL,(0.14±0.03)pg/mL and(0.35±0.09)pg/mL in non-infection group(t=13.135,7.403,20.475,16.112;all P<0.05).The age of first sexual activity in HSIL group was younger,and the proportions of the number of sexual partners>2,smoking,oral contraceptives and immunosuppressant use history were higher in HSIL group than those in non-HSIL group(χ^(2) or t=11.781,12.745,15.050,21.597,29.952;all P<0.05).The risk factors for HSIL were early sexual debut[OR(95%CI)=2.208(1.

关 键 词：阴道微环境 解脲支原体感染 沙眼衣原体感染 炎症因子 宫颈高级别鳞状上皮内病变 

分 类 号：R711.32[医药卫生—妇产科学]